Outrage and Bafflement Over Insulin Prices

The price of insulin is always a hot-button topic. Many in the diabetes community have expressed outrage at the climbing price for insulin and at disparities in the price of insulin.

Similar anger popped up at the ADA Scientific Session in Boston. At one presentation, doctors squared off for a debate on whether new generation insulins were worth it for treating Type 2 diabetes, but consensus soon emerged that diet and exercise were better initial strategies.

One physician taking the stage to debate on the side of early insulin therapy for Type 2 diabetes opened by saying, “I’m sometimes required, for the sake of debate, to take positions not necessarily in line with my practice.”*

What appeared at first to be a back-and-forth over the appropriateness of moving patients with Type 2 from traditional oral medications to insulin therapy soon became a bang-for-the-buck discussion on insulin prices in general. One presenter produced a graph showing how the prices for insulin made by the three leading manufacturers climbed upward while the cost of manufacturing insulin during the same time span only crept upward at a comparatively flat rate.

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At another session, a chart showed nine different prices offered by insulin manufacturers that were available to large pharmacy retailers, small independent pharmacies, pharmacy plans like Express Scripts, the federal government, national health care insurors, and clinical institutions, among others. As one physician in the discussion said, “I don’t see a lot of supply and demand economics at work here.” An audience member from across the Atlantic Ocean was less sanguine, reminding Americans that the Declaration of Independence speaks to a natural right to life, liberty, and the pursuit of happiness. “Insulin is necessary for life,” he said. “And therefore it ought to be free.”

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Another session on the cost of diabetes care featured a portrait of insulin innovator Dr. Banting with drawn-on tears coming down his face. Banting and a colleague won the 1923 Nobel Prize for their quest to purify insulin and save children’s lives; they decided to share the prize money with other colleagues. Once the team discovered the right method for making insulin as medicine, they sold their patent to the University of Toronto for the Canadian equivalent of what would now be $781 U.S. dollars. The university licenced it to insulin manufacturers royalty-free.

$781 is $107 less than the retail price of two five-pen cartons of a leading name-brand glargine at the CVS down the street from our office in Woburn, Massachusetts. It’s no wonder that so many people are upset at the price of insulin.

All quotes should be construed as approximate, as there was no recording equipment allowed in the ADA Scientific Sessions events.

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